Medpor支架及肋软骨支架法耳廓再造比较及研究.docVIP

Medpor支架及肋软骨支架法耳廓再造比较及研究[摘要]目的：观察两种耳廓再造术的临床应用和疗效，探讨较理想的耳廓再造方法。方法：对60例小耳畸形或外伤后耳廓缺损患者，分别行扩张器扩张乳突区皮肤后肋软骨作支架耳再造术（34例）和多孔高密度聚乙烯(Medpor)作支架颞浅筋膜瓣加植皮一期耳再造术（26例）。结果：经过6个月～5年观察，肋软骨组有2例支架外露，2例轮廓不明显，1例局部缺陷；Medpor组有1例支架外露，2例轮廓不明显，1例局部缺陷，总体满意率分别为85.3%和84.6%（P0.05），无显著差异。结论：以肋软骨作支架的分期耳再造术是较可靠的治疗方法，但Medpor作支架一期耳再造术只要了解Medpor材料的生物特性，选择合适的手术方法，掌握手术操作的各个环节 ,可以将手术并发症减少到最低限度，具有创伤小、操作简单、疗程短、术后效果稳定可靠等优点，是目前一种较为理想的耳廓再造方法。 [关键词]耳廓再造；软骨支架；多孔高密度聚乙烯 [中图分类号]R764.9[文献标识码]A[文章编号]1008-6455（2009）02-0179-04 Clinical applicative analysis and comparison of two kinds of auricle reconstruction by Medpor framework and cartilage framework HUANG Li, HE Lin, HU Ying, TANG Hong-bo,CHEN An-min (Department of Plastic Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030,Hubei,China) Abstract：ObjectiveTo observe the application and effect of two kinds of auricle reconstruction and find the idea one． Methods60 cases of congenital microtia or auricle defection after external injury were divided into 2 groups: Group A(34 cases), cartilage framework was wrapped by the extended auricular area skin; Group B(26 cases), Medpor auricular framework was wrapped by the superficial temporal fascia which was covered by skin graft.Results6 month to 5 years follow-up showed that there are 2 cases with framework exposure, 2 cases with unclear figure, 1 case with local defection in group A and 1 case with framework exposure, 2 cases with unclear figure, 1 case with local defection in group B. The cured auricle’s satisfactory rate was 85.3% and 84.6 % (P0.05) respectively in two groups. There was no significant difference in two groups.ConclusionsAuricle reconstruction with cartilage framework by stages is comparatively reliable, but if the organic characteristics of the Medpor framework are comprehended totally, auricle reconstruction with Medpor framework is an ideal one. By choosing the proper surgical method and skillfully operating during the surgery